Dr Johann D. Kluge

03/09/2025

Oral Cavity Cancer: Incidence & Risk Factors

Oral cavity cancer is more common than most people think.

Globally, more than 350,000 new cases are diagnosed every year. That is 2–3% of all cancers. In regions where to***co and alcohol use are widespread, the numbers are even higher.

In South Africa, oral cancers remain among the most common cancers in men. The challenge is that many patients only present when the cancer is already advanced.

The major risk factors are preventable:
•⁠ ⁠Tobacco in all forms
•⁠ ⁠Alcohol, especially when combined with to***co
•⁠ ⁠Poor oral hygiene, chronic irritation from dentures or broken teeth
•⁠ ⁠Low fruit and vegetable intake
•⁠ ⁠Family history

Key message: Oral cavity cancer is not rare. Awareness and early detection save lives.

01/09/2025

He has now issued a warning about the importance of wearing sunscreen

30/08/2025

Speech Therapist Appreciation Day!

Thank you for being the most amazing speech therapy team 💙

28/08/2025

Caregiving for a loved one with head and neck cancer is tough. H&N Connect is here to help—with six free, virtual sessions over 12 weeks starting September 1, 2025. You’ll get expert‑led videos, group chats, practical tips and emotional support. Space is limited - sign up now!

Find out more: https://www.headandneck.org/hnconnect/

27/08/2025

🦷 The Oral Cavity: Where It All Begins

The oral cavity—commonly called the mouth—is more than just teeth and tongue. It is the gateway to our digestive and respiratory systems, and it plays a vital role in speech, taste, breathing, and swallowing. Understanding its anatomy is the first step in recognising early warning signs of disease, including oral cancers.

The oral cavity includes:

Lips – the external entrance and barrier.

Cheeks (buccal mucosa) – the inner lining of the mouth.

Teeth & gums (gingiva) – essential for chewing and oral health.

Tongue (anterior two-thirds) – crucial for taste, movement, and speech.

Floor of the mouth – the soft tissue under the tongue, home to important salivary ducts.

Hard palate – the bony roof of the mouth, separating the oral cavity from the nasal cavity.

Superior labial frenulum – the small fold connecting the inside of the upper lip to the gum.

Uvula & soft palate – the muscular extension and soft tissue forming the back of the roof of the mouth.

Tonsils – lymphoid tissue important for immune defence.

Retromolar trigone – the small area behind the last molars, often overlooked but clinically significant.

🔹 The border between the oral cavity and the oropharynx:
At the very back of the mouth, the oral cavity transitions into the oropharynx. This boundary is defined by:

The anterior tonsillar pillars (arches on either side at the back of the mouth).

The circumvallate papillae on the tongue (the line of large taste buds at the back of the tongue).

Everything in front belongs to the oral cavity; everything behind forms part of the oropharynx (throat). This border is very important because cancers in the oral cavity and oropharynx behave differently, are staged differently, and may have different treatment approaches.

⚠️ Why does this matter?
Many oral cancers start in these regions. Changes in the mouth—such as non-healing ulcers, red or white patches, swelling, pain, or difficulty swallowing—should never be ignored.

👉 This post is the first in a series exploring oral cavity cancer, from risk factors and symptoms to diagnosis, treatment, and recovery.

27/08/2025

Join us in sunny Los Angeles on October 4 for the Head and Neck Cancer Survivorship Symposium!
This free event is your chance to meet others who understand your journey, hear from expert speakers, and find hope and resources. Can’t travel? We’ve got you covered online, too. Register today:
https://www.headandneck.org/symposium/

26/08/2025

If you or a loved one have been diagnosed with recurrent or metastatic head and neck cancer and have not yet started treatment, think about joining a clinical study.

In the HexAgon-HN clinical study, INBRX-106 is being evaluated as a potential new therapy for head and neck cancer.

Click this link to find out if you qualify and see if there is a clinical study site near you!
https://inhibrx.com/inbrx-106-phase-2-3-trial/

Reimbursement for certain travel costs related to study visits may be available. Contact a study center to learn more.

-106 -HN

18/08/2025

This weekend we managed a very big and complex case in surgery — a true reminder of the power of collaboration. From registrars to consultants, every person played a crucial role in ensuring the best care for our patient.

A heartfelt thank you to the outstanding team:
🩺 Prof Jan Pretorius
🩺 Dr Ben Moodie
🩺 Dr Wilna Bester
🩺 Dr Nicolette Erasmus
🩺 Dr Roseman Siganga
🩺 Dr Gillian Kisla

And to the theatre team who keep everything running seamlessly:
🔹 Scrub: RN Manu, RN Bronwyn, ODP Tumi
🔹 Nurses: ODP Grace, ENA Nester, ENA Rebotile, ENA Maria, Recovery RN Ntokozo
🔹 Visiting Medical student: Alan Huebner

This kind of teamwork is what makes complex surgery possible. Grateful to walk this journey with such dedicated professionals.

15/08/2025

15/08/2025

Complications After a Neck Dissection: What You Should Know

While neck dissection is a vital part of managing head and neck cancers, like any major surgery, it carries risks. Understanding potential complications helps patients prepare and recover more confidently. The best way to prevent complications is to be well prepared and to mitigate any risks. Know the anatomy and the surgical procedures being performed. Discuss the plan not only with the patient but with the entire team prior to the intervention.

⚠️ Common Complications

📍 Nerve Injury
Temporary or permanent weakness can result from injury to nerves such as the spinal accessory nerve (shoulder weakness), marginal mandibular nerve (lip asymmetry), or hypoglossal nerve (tongue movement). The golden rule in head and neck surgery – explore and identify the nerve, don’t avoid it. If you can see it, you can’t injure it!

📍 Seroma / Hematoma
Fluid or blood collections under the skin may occur post-operatively and sometimes require drainage. This is, however, not a common complication.

📍 Infection
Though rare, wound infections can occur and are managed with antibiotics and drainage of an abscess if present.

📍 Chyle Leak
A leak of lymphatic fluid from the thoracic duct, particularly in left-sided dissections. Often managed conservatively but may require surgical intervention. Once again, this is not a common post-operative occurrence.

📍 Cosmetic and Functional Impact
Scarring, altered sensation, and limited neck or shoulder movement are possible. Physiotherapy can aid recovery.

📍 Airway and Swallowing Changes
Swelling in the acute setting can impact swallowing or breathing in the early post-operative period. Monitoring is essential. A temporary tracheostomy tube may be placed as a precaution if there is any concern.

🧠 Every complication is managed proactively with a personalised recovery plan and multidisciplinary support to ensure the best possible outcomes.

14/08/2025

We celebrate the heart of the operating theatre 💙

Theatre nurses are the unseen backbone of surgery — calm under pressure, precise in every action, and deeply committed to patient care from the first prep to the final stitch.

Your steady hands, sharp minds, and compassionate hearts keep every procedure running smoothly. From anticipating a surgeon’s needs to providing reassurance to patients in their most vulnerable moments, your role is nothing short of extraordinary.

To all the women in healthcare, and especially our theatre nurses — thank you for your skill, strength, and unwavering dedication behind the surgical lights.

You are the quiet heroes. The difference-makers. The heart of healing.